Complications of tonsillectomy: a comparison of techniques.

OBJECTIVE To compare the postoperative complications of intracapsular tonsillectomy using a microdebrider with traditional electrodissection tonsillectomy. DESIGN Retrospective chart review. SETTING Tertiary care pediatric referral center. PATIENTS The medical records of 2944 patients undergoing tonsillectomy with or without adenoidectomy at our institution between January 1, 2002, and May 31, 2005, were reviewed. MAIN OUTCOME MEASURES Incidence of delayed postoperative hemorrhage, return to the hospital or emergency department for pain or dehydration, and the need for revision surgery. RESULTS There were 1731 patients in the intracapsular tonsillectomy group and 1212 in the traditional electrodissection tonsillectomy group. The incidence of delayed hemorrhage was 1.1% in the intracapsular tonsillectomy group and 3.4% in the traditional electrodissection tonsillectomy group (P < .001). For delayed hemorrhage requiring treatment in the operating room for control, the incidence was 0.5% in the intracapsular tonsillectomy group and 2.1% in the traditional electrodissection tonsillectomy group (P < .001). Treatment in the emergency department or hospital for pain or dehydration was necessary in 3.0% of the intracapsular tonsillectomy group and in 5.4% of the traditional electrodissection tonsillectomy group (P = .002). Eleven patients (0.64%) in the intracapsular tonsillectomy group required revision tonsillectomy. CONCLUSION Intracapsular tonsillectomy has a lower incidence of postoperative hemorrhage and pain leading to hospital-based evaluation compared with traditional electrodissection tonsillectomy.